Analysis Of Influencing Factors Of Esophagogastric Variceal Bleeding And Bleeding Risk Assessment In Cirrhotic Patients In Inner Mongolia

Objective To investigate the influencing factors of esophagogastric variceal bleeding in patients with cirrhosis in Inner Mongolia,and to evaluate the predictive value of these non-invasive serological models including APRI,FIB-4,King,MELD,MELD-Na,and Liaoning score for esophagogastric variceal bleeding.Methods According to whether there was esophagogastric variceal bleeding,226 cirrhotic patients with esophagogastric fundus varices were were divided into bleeding group and non-bleeding group.To compare the differences of the following data between the two groups:gender,age,smoking history,drinking history,season of onset,etiology,hepatic encephalopathy,ascites,Child-Pugh grade,blood routine,hepatic and renal function,ions,blood glucose,blood lipid,coagulation function,blood ammonia,alpha-fetoprotein,abdominal water volume,portal and splenic vein diameter and velocity,degree of esophagogastric fundus varices,and red color signs or not.Statistically significant indicators in univariate analysis were further analyzed by binary Logistic regression analysis to determine the independent risk factors for EVB.APRI,FIB-4,King,MELD,MELD-Na and Liaoning score of the two groups were calculated.Receiver operating characteristics curve were drawn,to evaluate the predictive value of risk factors and the above scoring models for EVB.Results 1.Single factor analysis showed LYM%,NEU,NEU%,RBC,HGB,PLT,ALP,TBIL,ALB,K,Cl,Ca,Mg,PT,INR,FIB,GLU,TG,portal vein diameter,portal vein velocity,hepatic encephalopathy,ascites degree,degree of esophagogastric fundus varices and red color signs were statistically different between the two groups(P<0.05),but there were no statistically significant differences in age,gender,smoking history,drinking history,onset season,etiology,Child-Pugh grade,blood ammonia and alpha-fetoprotein.2.The results of binary Logistic regression analysis showed that the degree of esophagogastric fundus varices,red color signs and NEU% were independent risk factors for esophagogastric variceal bleeding in patients with cirrhosis,while HGB and FIB were the protective factors.3.In terms of serological model,the difference between APRI,FIB-4,King,MELD and MELD-Na score was not statistically significant between the two groups.There was a significant difference in Liaoning score between the two groups(P<0.05),and the score in the bleeding group was significantly higher than that in the non-bleeding group(1.86 vs 0.42).4.The AUC of NEU%,HGB,FIB,degree of esophagogastric fundus varices,red color of varicose veins and Liaoning score in predicting esophagogastric variceal bleeding were0.644,0.598,0.771,0.757,0.760,and 0.934,respectively.Combining NEU%,HGB,and FIB with Liaoning score,the AUC could be increased to 0.947.Conclusion 1.The degree of esophagogastric fundus varices,red color signs and NEU% are independent risk factors for esophagogastric variceal bleeding in patients with cirrhosis,while HGB and FIB are the protective factors.2.Liaoning score has a high predictive value for esophagogastric variceal hemorrhage,FIB,the degree of esophagogastric fundus varices and red color have moderate predictive value,while NEU% and HGB had low predictive value.The combined application of NEU%,HGB,FIB and Liaoning score has higher clinical value to predict esophagogastric variceal hemorrhage in cirrhosis.